The Influence of a Crosshair Visual Aid on Observer Detection of Simulated Fetal Heart Rate Signals

Objective To determine whether a visual aid overlaid on fetal heart rate (FHR) tracings increases detection of critical signals relative to images with no visual aid. Study Design In an experimental study, 21 undergraduate students viewed 240 images of simulated FHR tracings twice, once with the visual aids and once without aids. Performance was examined for images containing three different types of FHR signals (early deceleration, late deceleration, and acceleration) and four different FHR signal-to-noise ratios corresponding to FHR variability types (absent, minimal, moderate, and marked) identified by the National Institute of Child Health and Human Development (2008). Performance was analyzed using repeated-measures analyses of variance. Results The presence of the visual aid significantly improved correct detections of signals overall and decreased false alarms for the marked variability condition. Conclusion The results of the study provide evidence that the presence of a visual aid was useful in helping novices identify FHR signals in simulated maternal-fetal heart rate images. Further, the visual aid was most useful for conditions in which the signal is most difficult to detect (when FHR variability is highest).